I’ve lost track of how many times I wish I had a magic switch I could just flip to the “off” position…
Table of Contents
Exit Plan
I’ve lost track of how many times I wish I had a magic switch I could just flip to the “off” position…
Click.
No more pain, fatigue, or weakness.
No more regrets, worries, fears, or anxieties.
No more needle sticks or IVs.
No more ultrasounds, X-rays, CT scans, MRIs, bone scans, and PET scans.
No more surgeries or invasive procedures.
No more wounds or sutures.
No more infections or antibiotics.
No more EKGs, blood draws, or urine samples.
No more infusions or radiation.
No more false negatives or false positives.
No more biopsies.
No more colonoscopies, EGDs, or cystoscopies.
No more waiting, waiting, and more waiting.
No more mindless and heartless bureaucracy.
No more telephone tag.
No more medical bills.
No more cracked teeth.
No more hard decisions.
No more having to file an effing tax return.
Of course, this magic switch would provide instant and totally painless relief for my survivors as well—leaving them all without grief, guilt, regrets—and with nothing but happy memories of me.
Such a switch does not exist, of course.
If such a switch did exist, I would have flipped it on many occasions—without hesitation—and without even a hint of sadness, guilt, anger, doubt, or fear.
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The “S” Word
My exit plan does not include the “S” word…
… for at least five reasons:
- I’d never put anyone through the anguish of wondering why Frank isn’t answering his phone, texts, emails, or doorbell.
- I’d never put anyone in the position of having to deal with the messy aftermath.
- I’d never put anyone in the position of feeling guilty for not seeing it coming and for not doing something about it.
- I’m afraid I might botch the job and leave myself in even worse shape than I was before.
- I’m afraid I might botch the job and become so incapacitated that I’m unable to communicate and control what happens to my body.
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Depression
I have never considered flipping that mythical magic switch because I was depressed…
I have considered flipping it…
… because I was in horrific pain.
… because I was emaciated and puking my guts out.
… because I was so weak and exhausted that I could barely lift my head off the pillow for days on end.
… because I was so weak and exhausted that I didn’t take a shower for weeks.
… because I was so weak and exhausted that all I could stomach was a single Ensure shake choked down once a day for weeks.
… because I was terrified of suffocating.
… because I was so weak I couldn’t open a jar of spaghetti sauce. (I just laid down and went without eating for yet another day)
… because I felt totally emasculated.
… because I felt totally useless.
… because the ability to do the things that gave my life meaning were stripped away from me.
… because I feared being incapacitated and intubated.
… because I feared being put on life support against my wishes.
… because I didn’t want to be a burden on anyone.
… because I saw no dignity in pointless suffering.
I repeat: I have never entertained flipping that mythical magic switch because I was depressed.
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Bodily Autonomy
The morality and ethics of dying with dignity are perfectly simple, rational, and humane…
Nobody else has the right to dictate what I can or cannot do to my own body. I have the inalienable right and freedom to choose as I please—as long as it does not infringe upon the freedom, health, or safety of anyone else.
Likewise, nobody has the right to dictate what another knowledgeable, skilled, and compassionate human being can do to help me peacefully and painlessly enter the eternal sleep—at a time, place, and manner of my choosing—and with the same care and love that any decent person would bestow upon a beloved, suffering animal.
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Thank You, Elizabeth Whitefield
June 18, 2021–the day an enormous weight was lifted from my shoulders…
… the day the New Mexico “End-of-Life Options Act” went into effect.
Prior to that date, I did not live in a Death with Dignity State.
Prior to that date, deciding where to live was a source of extreme stress and a matter of utmost urgency.
Prior to that date, the specter of unenviable alternative exit plans followed me everywhere.
It’s impossible to describe the magnitude of the relief and comfort I derive from knowing I now have the option to die live with dignity when the time comes.
Thank you, Elizabeth Whitefield.
And thank you Deborah Armstrong, Dayan Hochman-Vigil, Liz Stefanics, Bill O’Neill, Michelle Lujan Grisham, and countless other heroes who scored this major victory for human decency, compassion, and kindness.
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Medical Aid in Dying Law
For the small but growing list of states that have Medical Aid in Dying (MAID) laws in place…
… the rights, procedures, and protections for both the patient and their health care providers are clearly and sufficiently defined and delineated.
For example, in order to quality for life-ending medication in the state of New Mexico (under the Elizabeth Whitefield End-of-Life Options Act), one must be:
- A New Mexico resident.
- At least 18 years of age.
- Diagnosed with a condition or illness that is incurable and irreversible and likely to cause death within 6 months.
- Mentally capable of making and communicating an informed decision.
- Physically capable of self-administering the life-ending medication.
Once the above criteria are met and a prescription for aid-in-dying medication is written, the prescription may be filled only after a forty-eight-hour wait period.
Importantly, participation is always voluntary and based on informed consent. The patient can opt out at any time and no healthcare provider is ever required to participate.
To my knowledge, each the medical aid in dying law in each death with dignity state follows the same blueprint.
I encourage you to download and read the New Mexico Aid-in-Dying Legislation for yourself (6 minute read): Elizabeth Whitefield End-of-Life Options Act.
I’ve read every word and am perfectly at ease knowing that my rights will be protected, that I will never lose the power of informed consent, that my healthcare providers will be adequately trained, that these compassionate healthcare providers would be protected by law, and that all the procedures required will ensure the integrity of all the above.
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Suicide Prevention
I don’t want to die. I want to LIVE…
In other words, I’m not suicidal.
I’ve never been suicidal.
I’ve never wanted to die.
I’ve always wanted to LIVE.
And now thanks to having the option of medical aid in dying, I don’t anticipate ever becoming suicidal.
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Right to Life
The right to end my own life peacefully and painlessly is not about the right to die but about the right to LIVE…
The right to live without pain.
The right to live with purpose.
The right to live without being a burden on others.
The right to live knowing that I am not consuming financial and human resources better spent on serving others who could truly benefit from them.
The right to live knowing that my estate is not being squandered on life support or palliative care that merely prolongs suffering and postpones the inevitable–knowing that my estate will instead be reinvested in causes I care about.
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Palliative Care
It’s easy to find stories suggesting that palliative and hospice care…
… do an adequate job making patients “comfortable” and allowing them to “pass peacefully”.
Alas, horror stories are easy to find as well.
Like most things in life, the quality of your medical care depends. It depends on where you live, who your doctors and nurses are, the decency of your health insurance, and a host of socioeconomic, political, and religious factors.
But even if palliative and hospice care really did make me “comfortable” and allow me to “pass in peace”, so what?
Because physical pain avoidance isn’t the only reason to choose medical aid in dying.
Because no matter how “comfortable” and “peaceful” the process might be for me, I don’t want my family and friends to watch me slowly wither away. I want them to remember Frankie at his most vital, stubborn, and courageous best.
Because no matter how “comfortable” and “peaceful” the process might be for me, I don’t want to disrupt anyone’s lives being on “death watch”–stressing over how many more weeks, days, hours, and minutes Frankie has left.
Because maybe I don’t want to outlive my usefulness–no matter how “comfortable” and “peaceful” that useless existence might be.
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Advance Directive
I don’t know what the future holds…
I don’t know what course my cancers will take.
I don’t know what complications and medical crises await me.
I don’t know how fast things will progress.
I don’t know if I’ll lose the mental capacity to make and communicate an informed decision.
I don’t know if I’ll lose the physical capacity to self-administer the life-ending medication.
And, even with the option of medical aid in dying, I still fear being conscious and losing control of what happens to me.
Should I lose such capacity, the best I can do (legally) is to have an Advance Directive (sometimes called a Living Will) that clearly communicates my wishes and grants power of attorney to one or more trusted agents who fully understand and support those wishes.
In a nutshell those wishes are: Do not prolong life. Sedate me. Keep me pain free. Withdraw all food and water. Do not resuscitate.
Please just let me go in peace.
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The Case for Exceptions to the Law
In light of the medical ethics questions raised and resistance of society at large to face the realities of death and dying with honesty and maturity…
… the guardrails and requirements defined by current medical aid in dying laws–namely age (at least 18 years), life expectancy (less than 6 months), wait time (at least 48 hours), and mental & physical capacity–may not be unreasonable baselines, but it seems to me that there should be a provision for making exceptions in exceptional cases.
Maybe someday.
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Paying It Forward
I can never repay the enormously comforting gifts of choice, autonomy, compassion, and dignity I’ve received from so many empathetic, hard-working heroes–doctors, nurses, researchers, engineers, legislators, lawyers, and patients–who’ve made my right to die with dignity an option.
But I’m paying it forward by speaking openly and honestly about the subject and by being a sustaining donor to DeathWithDignity.org (which also figures significantly in my estate planning)…
… in the hope that the basic human right to live and die with dignity might become an option for everyone someday.
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Frank’s Cancer Story continues… Getting My Affairs in Order
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My mother died of cancer 22 years ago. She was already beyond palliative but still living in their house. Until one day, when she had massive bleeding. I called the ambulance, took her to the hospital. Her oncologist came and gave me a beating:
“That is not good, she’s extremely dehydrated…”
I cut him short and said:
“Doctor, she’s not dehydrated. She’s dying. Do whatever blood transfusion is needed and keep her out of pain. AND. If she goes, DO NOT try to bring her back.
Doc didn’t say a word. Turned around and left. My mother died 3 days later. She was at peace.
Thanks so much for sharing your experience and perspective… and for not shying away from the subject, brother. You and I are definitely on the same page. Thanks and peace.
I imagine lots of people shy away. But, but… there have been a number of tragedies in my family. Facing up is the only way.
Be good, Bro.
Hearty fist bump!